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Doctors in San Francisco are seeing the reappearance of Kaposiís sarcomaóa once-common AIDS-related condition that afflicted roughly one third of patientsóamong a handful of longtime HIV patients. The doctors do not know why Karposiís sarcoma (KS) is being seen again in patients.

Kaposiís sarcoma, a lesion-causing skin cancer, became less prominent in the Western world with the introduction of improved antiretroviral treatment. However, nine cases have been reported in San Francisco between 2004 and 2006 among people diagnosed an average of 18 years ago and who have taken antiretroviral drugs for around seven years.

While none of these cases of KS are severe or untreatable, the reasons for the reoccurrence remains a mystery.

Google returns this reference:SOURCES: Toby Maurer, M.D., associate professor of dermatology, University of California, San Francisco, and chief of dermatology, San Francisco General Hospital; David Aboulafia, M.D., clinical professor of medicine, University of Washington, and attending hematologist/oncologist, Virginia Mason Clinic, Seattle; Sept. 27, 2007, New England Journal of Medicine

Within each of these news "blurbs" on POZ.com (and AIDSmeds.com), there's almost always a link to the source of the information. In this case, it was a report published by a newswire service -- HealthDay News -- that was picked up by U.S. News and World Report.

To be even more specific, the HealthDay News article is a summary -- not a very thorough one, I'm afraid -- of a letter published in the most recent New England Journal of Medicine (as Matty points out). Here's the full text of the letter:

HIV-Associated Kaposi's Sarcoma with a High CD4 Count and a Low Viral Load

To the Editor: Kaposi's sarcoma associated with HIV infection has been decreasing in incidence and severity since the introduction of antiretroviral therapy.1 These reductions have been attributed to improved immune function directly related to such therapy. Patients with Kaposi's sarcoma typically have a low CD4 cell count (<150 cells per cubic millimeter) and a high viral load (>10,000 copies per milliliter).1,2 In the majority of patients, the regression of Kaposi's sarcoma lesions has been reported to occur within 8 months after the initiation of antiretroviral therapy, paralleling the increase in the CD4 cell count and decrease in the viral load that mark successful therapy.3 Likewise, progression of Kaposi's sarcoma has been associated with a high viral load, a low CD4 cell count, and concomitant opportunistic infections.2,3

We report on a cluster of unusual cases of cutaneous, unremitting HIV-associated Kaposi's sarcoma occurring in nine patients with sustained CD4 cell counts of more than 300 cells per cubic millimeter and suppression of the viral load to a value below 300 copies per milliliter for at least 2 years. These patients presented between November 2004 and January 2006. All were receiving antiretroviral regimens containing at least one protease inhibitor or non-nucleoside reverse-transcriptase inhibitor. The median age was 51 years (range, 41 to 74), the median time since the onset of HIV infection was 18 years (range, 4 to 25), and the median duration of antiretroviral therapy was 7 years (range, <1 to 19). The median nadir CD4 cell count was 340 (range, 90 to 455). None of the patients had a history of opportunistic infections. The patients have had a relatively indolent course of Kaposi's sarcoma, with no eruptive cutaneous lesions, visceral involvement, or other AIDS-defining illnesses.

This cluster of cases of persistent HIV-associated Kaposi's sarcoma in patients with HIV viral suppression and good immune-system function (as measured by the viral load and CD4 cell count) is important for three reasons. First, although there have been sporadic reports of similar patients,4 it is possible that we are seeing a greater number in San Francisco because of the high number of aging patients who are infected with both HIV and human herpesvirus 8. This hypothesis raises questions about the immune system's integrity and ability to control certain viruses in patients with long-standing HIV infection.5 Second, it has been postulated that drug regimens containing protease inhibitors are preferable in the treatment of Kaposi's sarcoma because of their antitumorigenic and antiangiogenic effects. In our series, seven patients have been receiving protease inhibitors without improvement in their Kaposi's sarcoma. Finally, these patients present a clinical and prognostic conundrum in that they are receiving maximal antiretroviral therapy yet have persistent Kaposi's sarcoma. This phenomenon may increase in frequency as the HIV-infected population ages, and we recommend that physicians monitor this group carefully.

Rumors of the reported phenomenon circulated in SF about a year ago. A doc checked it out with "health officials" and it was dismissed as "another rumor."

In my KS support group there were a couple of guys who had 600 + tcells who had alternating cycles of dormant and proliferative KS. Our group stopped meeting because everyone at that point in time had the KS undercontrol. We suggested years ago that this subset of HIV controlled/proliferative KS should be studied.

In my own case, my KS with 30 lesions including one on my face, has been dormant since 1996 after 30 days of crixivan. The crix stopped the KS in its tracks...lesions flattened, lightened, and almost all disappeared overtime...and that was prior to my t cells going back up. T cells bottomed out at 26. They rose very gradually over many months. Recently they are 940, highest ever, and have no KS return for over 10 years.

I was initially concerned about whether my KS would reactivate when I went on treatment interruptions. It never did. Not even sure if I am still HHV-8 positive....but I assume I have it like with herpes infection...since its a herpes virus.?

I include my experience because I don't think that anyone with KS should freak out about this report of a small subset of people where KS returned despite HIV being controlled. Hank

I have mentioned this here before, but there is no link or documentation. THIS IS STRICTLY ANECDOTAL:

My dermatologist here in N.Y.C., who has been involved with KS and AIDS since the beginning in 1981--indeed, he worked with Dr. Alvin Friedman-Kien at N.Y.U. in the first reporting of the KS cases--told me last year that he is seeing an unusual increase of KS cases among HIV-NEGATIVE gay men. He could not offer an explanation when I asked what might be causing this. He did say that they were not of Mediterranean stock and that their immune systems were in normal range. I specifically asked him about this because I have a (gay) friend, HIV-negative, who has been diagnosed with KS.

Logged

"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

Researching hiv negative gay guys may shed light on the KS/HHV-8 mystery and explain the disproportionate prevalence of HHV-8 and KS among gay men. I've requested that researchers studying HHV-8 and KS in gay men include an assessment of recreational drug use.

Some recreational drugs are immunosuppressive and whether transient or chronic immunosuppression may be a factor in HHV-8 seropositivity or development of KS warrants exploration. Researchers in the KS field have been inconsistent in assessing recreational drug use. And when there has been assessment there have been variations in how drug use was measured. Some of this aversion to assess recreational drug use may be a reaction to AIDS denialism since Duesberg and the HIV/AIDS denialists focused on popper use and the high prevalence of drug use among gay men. While the resulting aversion is understandable, it may obscure contributing factor(s) leading to HHV-8 positivity and KS.

Do poppers stimulate HHV-8 replication?Do the quantity of sniffs or the frequency of popper using episodes effect the degree and duration of immunosuppression?

Have doctors/ dermatologists given any feedback about the potential role of poppers in HHV-8 or KS?

I'm sorry, but if poppers caused KS wouldn't we have seen massive amounts of it for decades now? I really question this line of inquiry that you seem to continually insist on. Do you do poppers daily or something and have some major guilt thing going on?

If you took a pool of 100 gay men that had HIV and did poppers, and 3 of them got KS what exactly would that tell you anyway?

Are you insisting that the issue or questions about an association between poppers and KS/HHV-8 cannot be raised? That research about poppers being associated with KS/HHV-8 not be cited?

I understand its a controversial issue and make inquiries whenever there is research or reports about HHV-8 or KS among gay men/msm.I have KS.I want all potential cofactors for HHV-8 and KS examined.I will predictably ask about poppers use in any research about KS/HHV-8 among gay men. My intention is to get information and point out when popper use is ignored, or not reported.

As for the 3 guys who developed KS, I would be interested in the history of their recreational drug use including poppers.Quantity and frequency of popper use? Rationale :"Strong dose dependent relation between popper use and HHV-8 infection has been found consistently in epidemiological studies"."The question of whether the relation between amyl nitrite and HHV-8 is biological or behavioral remains unanswered." Corey Casper et al. "HIV serodiscordant sex partners and the prevalence of human herpesvirus 8 infection among HIV negative men who have sex with men: baseline data from the EXPLORE Study" in Sexually Transmitted Infections 2006; 82:229-235.

That EXPLORE Study was quite large with 4700 hiv negative gay men and found prevalence of recent popper use 37%...high enough to warrant attention. And at study end recent popper use rose to 52%.

My motivation goes back to 1981 when I started researching the effects of poppers because my sex buddy was a heavy popper user who never had sex without them. I also used them. We wondered what was already known about the poppers we and our peers were using....some of us quite heavily. I found research indicating that poppers were potentially hazardous. Questions were raised about poppers being carcinogenic prior to the AIDS epidemic. I continue focusing on poppers because their prevalence of use is high and many users are unaware that they are immunosuppressive. I was first approached by the poppers industry in 1981 reassuring me that poppers were harmless. I'm motivated to combat the ommissions and distortions put out by an apparently thriving poppers industry. Two gay doctors were also working on the poppers issue but they died. I'm carrying on their work to educate gay men.

Over the years, feedback from the gay community has been mixed. Some guys thankful for the information and the perspective on why poppers are potentially hazardous. Others have been hostile as if I'm making up the research or telling them what to do.

I motivated the SF Chronicle to cover the KS resurgence story in the hopes that if there are more of these cases they will be relayed to the UCSF researchers and perhaps we'll get some clues to solve the KS/HHV-8/gays mystery.

I'm interested in what doctors and service providers say about poppers and also this resurgence of KS in some PWAs, also in the phenomenon of KS in HIV negative gay men. Hank

Seems the current prevalence of poppers use has increased in recent years, but its not as high as when AIDS surfaced in the early 80's. Use was rare by the late 80s and has crept back up since the federal ban on sales in 1991.

Poppers was always a sex drug. But it was also a visible disco drug at one time. Not sure if its a dance drug like it used to be. I assume not...but

Seems the current prevalence of poppers use has increased in recent years, but its not as high as when AIDS surfaced in the early 80's. Use was rare by the late 80s and has crept back up since the federal ban on sales in 1991.

Poppers was always a sex drug. But it was also a visible disco drug at one time. Not sure if its a dance drug like it used to be. I assume not...but

Do you have some data to back up your claims on the rise in prevalence or is this just some seat-of-the-pants assertion? The only effect I recall of the 1991 ban was a quick reformulation of what goes into the bottle.

As far as being used on the dance floor, it was still done in tired places like Virginia and Baltimore in the 80's. By the time I moved to NYC in the late 80's it was considered very gauche to do so, and a quick sign you had no money for ecstasy. I never saw it after that unless it got spilt on me in a sling at Lou Maletta's sex club.

I have some data which I'm searching for...its in a pile???..its bright yellow...shows dramatic decline from early 80's to almost nothing by 89 then creeping back up. The EXPLORE Study data surprised me....especially the creep from 37% to 52% by the end of the prevention intervention.

My HIV-negative friend (who's Irish, by the way) and has KS says he has never used poppers. He also says he's never used any type of recreational drug. I know him well enough to believe him. (He's never even gone to a disco--ever.) His "drug" of choice has always been, and still is, alcohol.

Logged

"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

You would think that with the technological advances we now would have found a relation between the molecules of poppers and the genetic problems that lead to KS tumors. I'm surprised that someone that is so involved in this topic would just rely on studies that have no scientific back up. I'm not familiar with the subject so maybe i'm missing something.

Milker and Philly: I shared some data presented at an international AIDS conference. I'm not relying on it. The numbers presented indicate use in the past and illustrate that Use patterns changed drastically by the end of the 80s. As for today, the 4700, multi city EXPLORE STUDY is more recent covering the period of 1999-2003. Prevalence of use was 52% in the cohort of HIV negative gay men. Prevalence of use in an AIDS Health Project study 2002-2004 found 35% used poppers in past month and 72% had used poppers at some point in the past.

Hardly stuck in the 80s. I'm using this website to alert folks about a new phenomenon and also pointing out an area of inquiry. Isn't sharing info one of the points of this website? Also sharing perspectives, which we're doing.Getting stuck is a two way street. Some seem stuck in a view that poppers are harmless and not related to HHV-8 or KS. Any verdict may be premature with questions remaining about the KS mystery.

Edfu: Thanks for the info about your HIV negative friend who never used poppers or recreational drugs. I have lung cancer but never smoked. I'm in the subset of never smokers who was surprised by lung cancer. My non smoker subset with lung cancer does not invalidate the association with smoking. I think it illustrates the complexity of these conditions, that they might be multi factorial.

In some studies, the data is already there to be mined,interpreted, and reported. I questioned a researcher at an AIDS conferences about the data on popper use. Two weeks later, the researcher called and thanked me. Turns out they had not run the data on popper use and it turned out to be the greatest risk factor for HIV infection in the cohort they were studying. The MACS database was recently analyzed and found associations between HIV infection and meth and poppers use. Finding an association is a starting point informing the exploration and hopefully understanding of risk factors.

In Africa, HHV-8 positivity rates vary between countries. Seems reasonable to variations in behaviors...child rearing practices, saliva exposure variations, etc. It appears that the mode of transmission is not sexual like it seems in gay men, given the prevalence of the virus in kids. I'm not aware of anyone claiming that nitrite use is a factor is KS/HHV-8 positivity in Africa.

After HHV-8 was discovered in 1994, I thought the ,mystery about KS in gay men was solved. Some gay men with HHV-8 progress to KS, others dont. What are the factors? Seems reasonable to invest in answering this question. Not the biggest priority, but worth bucks, or time for those already funded.

Yes Hank, but you have an agenda with poppers. It's why you've been singularly focusing on it since 1981, wrote a book connecting it with AIDS in 1985 and continue to be obsessed with it 25 years later.

I don't get it. No disrespect but I don't.

In fact, it seems a large portion of the poppersmyth web site continually questions you on this pursuit. The more I read there, the more holes I see in all of your arguments and I don't have the energy to run around in circles with you on this topic.

Please show me the chemical proof that poppers is linked with KS. It's that simple.

Studies about percentages of people taking poppers and getting KS doesn't tell me anything. Once again, we are in 2007 and able to make at least a relation between KS and poppers by chemical study. Where is this study.

For consideration, that website is a poppers industry website. There are parallels to the tobacco industry intentionally misleading consumers. Note the dates on each commentary. The site dismisses all the published research on poppers. I'm the messenger, not the researcher. There are multiple researchers from multiple credible research institutions publishing their findings in scientific journals, acknowledging limitations of their research,raising questions needing further exploration, and making recommendations.

Consider:

1.In general, the published studies finding immunosuppression seem compelling. The Dax study on the effect of poppers on the human immune system stands out. Suppression of natural killer cell function taking 4 days to return to baseline seems important. the immune system continued stimulated for over a week- seems important and not desirable if the virus has gotten a foothold. www.pubmed.gov 1685501

2.The recent study by HL Fung found that protein expression of VEGF (vascular endothelial growth factor) and hepatic mRNA were significantly stimulated. Fung states "The development of KS is extensively linked to VEGF and its receptors, the purported link between inhalant nitrites and KS may be explained mechanistically, at least in part, through stimulation of VEGF expression by these inhalants." Effects of inhalant nitrites on VEGF expression: A feasible link to Kaposi's sarcoma?" in Journal of Neuroimmune Pharmacology 2006, June 9:1-11.

3.The Soderberg study which found increased tumor growth in mice exposed to poppers." Exposure of these mice to inhaled isobutyl nitrite increased tumor incidence and growth rate by almost 4-fold." www.pubmed.gov 10048747

A limitation of Soderberg's work is that minimal data is presented in each of his papers and the same work is presented in more than one publication. Occasionally researchers will do this to increase their publication volume and it does not reflect that a large amount of data has been generated. In many of Soderberg’s articles, Hank Wilson is acknowledged for providing the nitrites, which indicates bias. It appears that Wilson and Soderberg are associates and considering Wilson’s zeal against nitrites, the research by Soderberg is very suspect. Hank Wilson formed the one man Committee to Monitor Poppers. Wilson's has publicly stated that his boyfriend, who always used poppers with sex and had KS, died of AIDS. Wilson has also publicly acknowledged that he himself was diagnosed with AIDS in 1987. Therefore, it is likely that Wilson has a personal vendetta against nitrites.

Dr Ringold's view of Soderberg's work from the link provided by Philly.

Who is Dr. Ringold? anyone know where she got her degree? any publications?

As for proof of the website. That website used to be a link on wikipedia. under poppers but it was challenged by another viewer as a poppers industry propaganda website. The person making the allegation said he ran a special program to see who the owner of the site was and it was Pacific Western Distributing...if I remember correctly. PWD is a popper selling company.

I sent one bottle of RUSH to Soderberg when he started doing research on poppers. Not several articles. There is one article where he acknowledges me. One is not several. I did assist Soderberg with getting his NIDA grant renewed. He appealed a denial and by chance I called to check on the status of his renewal application. I then sent him all the published research I had compiled. He revised his application adding citations and it was approved. Soderberg told me that he wasn't aware of half the published studies. That motivated me to continue updating the bibliographies I distribute to researchers and HIV service providers. Saves them time. Everyone doesnt have access to medical libraries and pay to view journals. I'm lucky to access UCSF Medical library which one of the world's best...I was told.

A blanket dismissal of Soderberg's research? I would expect that from a popper's industry hired gun. Can't prove that. But dismissive of all the published research, including all the non Soderberg research?

I'm motivated out of concern for my community. If the misinformation,distortions, omissions of information was not happening, I would be less motivated to continue working on educating folks about poppers. I continually meet gay guys who know almost nothing about poppers. That is very motivating. Hank

Two gay doctors worked to educate gay men about the hazards of using poppers. Dr. Richard Hamilton did a 500 gay male survey about poppers back in 1977 in San Francisco. Dr. Tom Smith joined the Committee to Monitor Poppers in 1981 and successfully lobbied the SF Health Department to publish the first pamphlet on poppers which the Committee to Monitor Poppers produced in 1985. Both Hamilton and Smith died of AIDS. Hamilton was on the California State AIDS Advisory Committee which successfully lobbied for a state mandate that a warning be posted wherever poppers were sold. Gay Dr. David Ostrow was early president of American Physicians for Human Rights and initiated research looking at the role of substance use in HIV transmission. Ostrow continues to focus on the roles of poppers as well as crystal meth and other recreational drugs. Hank

For someone who has spent more than ten years continually claiming that ďthe use of poppers is increasing across the boardĒ, I find it quite remarkable that the only Ďevidenceí you have for this claim consists of some scribbled note which purports to have been copied from an OHP slide, which claims (but not very convincingly so) to show the use of poppers amongst the ďSan Francisco General Hospital CohortĒ Ö starting in 1981.

Pardon me for quibbling, but exactly which"Ďcohort" was it they were interviewing in 1981? To get a result of 36%, you would have had to have at least ten respondents (three of them being self-confessed ďheavyĒ poppers users); but, by 1981, all the hospitals in San Francisco (let alone the one single one you claim the cohort represents) werenít treating ten people identified as suffering from what was to become known as AIDS.

.. or are you perhaps just claiming that they decided to help you out by making ďare you a heavy user of poppers?Ē a standard question asked of all patients being admitted to San Francisco General Hospital and that this mysterious Ďcohortí is therefore in fact all patients of the hospital? .. which of course makes the claim even less believable than it already was.

Smooth, apparently I have you to thank personally for the fact that I can't buy the REALLY good poppers in the U.S. anymore, eh?

Look: feel free to continue charging the Jungle Juice windmills here all you like, and I'll just do my best to ignore it. But before you go charging off thinking you are speaking on my behalf in trying to get something banned again, I'd like to gently remind you here that you are not. OK?

But for the life of me, I cannot understand why you are so single-minded on this crusade of yours. If it was me and I knew that my name was getting appropriated by the denialist ranks AND I knew that another Hank Wilson was a known denialist AND I knew that my continued personal popper crusade was only serving to blur the lines and fuel the confusion between myself and the denialist movement, I cannot help but think I would try to cool my jets a bit on this one issue (and its TENUOUS at best link to KS) and instead focus what good name I have made for myself and valued history of activism I possess into a more immediate and tangible area for PWA's.

But that's just me. Like I said, oh Don Quixote of the nitrate world, if that's your thing...charge on.

Okay, at the risk of sounding really, really, really ignorant and obtuse, can someone please tell me who this guy Hank Wilson is? (I assume "Smoothstone" is Hank Wilson.) What, if any, are his qualifications to discuss the possible role of poppers in either immunosuppression or the development of KS?

And Philly, do you know about this Lisa Ringold person? I was reading the site to which you linked, but I'm wondering how legit it is. I'm not saying it's not, I'd just like to know whether it is, in fact, a site sponsored by manufacturers of poppers. Obviously, if it were, that would increase my skepticism about the validity of its claims.

As someone who enjoys using poppers, I'd just like to find a source of credible info on this topic.

The questions and feedback are motivating to develop a website to educate folks about poppers and to simultaneously battle both the poppers industry and the HIV/AIDS denialists. Multiple battle fronts. The need to educate consumers/potential consumers/service providers about poppers will continue. Poppers are not going away, nor is the controversy.

Any recommendations to get free/public interest assistance for website design? Thanks. Hank

It's all a bunch of bullshit. Amyl nitrate was used over a hundred years before the beginning of the AIDS epidemic for heart patients -- where was all this nasty KS then?

There's so much swiss cheese logic in your "case" Hank as to make it laughable. No wonder you have to come on an AIDS web forum to beg for free web site design for your 25 year old jihad that's gone no where.

Its a work in progress.( which can be shaped by feedback and questions) A goal is to develop a repository about poppers: research, history, perspectives, issues, and questions that is updated as information, research, and news develops.

Thanks for sharing perspectives and questions. The support and constructive suggestions were motivating.

Philly: Researching the interesting question about all those heart patients who used poppers since the discovery of amyl nitrite. Was the use by heart patients similar to contemporary popper users? There is a spectrum of use among contemporary users, did the heart patients also have light,moderate, heavy users? Was frequency of use rare, periodic, frequent, regular?

I took Smoothstone's advice and Googled "Hank Wilson San Francisco." What I discovered is that Mr. Wilson appears to be associated with Michael Petrelis, the self-annointed AIDS activist here in San Francisco. I know Petrelis from my days in Washington, D.C., and in my view, he's a disgrace to the community. This post by Gabriel Rotello will tell you more about Petrelis's antics: http://www.huffingtonpost.com/gabriel-rotello/deadly-error-alert-andre_b_54626.html. Wilson's association with Petrelis is enough to discredit him in my eyes.

I took Smoothstone's advice and Googled "Hank Wilson San Francisco." What I discovered is that Mr. Wilson appears to be associated with Michael Petrelis, the self-annointed AIDS activist here in San Francisco. I know Petrelis from my days in Washington, D.C., and in my view, he's a disgrace to the community. This post by Gabriel Rotello will tell you more about Petrelis's antics: http://www.huffingtonpost.com/gabriel-rotello/deadly-error-alert-andre_b_54626.html. Wilson's association with Petrelis is enough to discredit him in my eyes.

bobino,

you are running into the same thing i did here in this thread awhile back:

further, Tim Horn made a statement about this confusing situation in the "ks connection" thread. i'm still confused, i must say. that was what i was referring to in my post just above this one. smoothstone made some form of "answer" narrative (which i plan to go back and reread shortly). i seem to recall something to the effect of there being more than one Hank Wilson. this one and an evil doppleganger or some such. i have to say it all seemed rather convoluted at the time. i think smoothstone said that his good name was constantly being appropriated by the denialist team and he couldn't keep up...which was also why i said time might be better spent at the computer or elsewhere setting himself apart from the denialists...but instead he seems to choose to hack away at this same murky poppers area from which he and so many in the denialist camp emerged. all so very odd.

i am extraordinarily exhausted right now...eyes are blurring as i type this and bed soon beckons. the short version is that you (and everyone here) should revisit that other thread.

Research on poppers in the context of AIDS and Kaposi's Sarcom - An important accomplishment of the Committee to Monitor Poppers:The Dax human study on the effect of poppers on the human immune system has enduring value. Limitations acknowledged. We pushed Congress to mandate NIDA to do the human study and report back in 6 months. Transition from mice to humans ..overnight. The finding that poppers Suppress natural killer cell function is alarming. Significance of the immunosuppression? Enough to increase susceptibility to infections...like HIV? worthy of further research, especially in the context of high prevalence of use among gay guys. Unfortunately, NIDA went back to their mice/rat study mentality and protocols after meeting Congress's mandate.

Hank Wilson successfully pushed for employment protection for gay teachers in SF in 1975. The SF Board of Education voted 7-0 for a non discrimination policy which omitted sexual orientation. Wilson and two other teachers came out publicly the next day and rallied the community. It was a natural evolution of his gay activism to focus on the gay health crisis emerging in 1981. Formed Committee to Monitor Poppers in 1981....long before AIDS denialism...in the context of the emerging and spiraling epidemic. In 1982, Wilson and gay activist nurse Bobbi Campbell, first public person with AIDS, formed the AIDS Political Action Network in SF and got the California Nurses Association to issue a call for government response and funding to the spiraling and frightening epidemic. Joined with SF PWAs in organizing the first AIDS Memorial Candlelight March in 1983. Hank made the call to NYC's Larry Kramer and GMHC President Paul Popham, deceased PWA, seeking their participation in a simultaneous AIDS Candlelight March in NYC. The goal was to put a face on AIDS. Not just t cell numbers, numbers of partners, numbers of recreational drugs,ages of those getting sick and dying, numbers of sick and dead.......but faces.Mission accomplished. We had no shame, any of us could have whatever IT was. we all had fear of the disease and society's reaction to us, a lack of confidence in governments to respond. The pink triangle symbolized our fear and motivated our community to action.Arrested at the Univ of Calif. Regents meeting in 1985 protesting the failure to increase the AIDS research budget. In 1984 Cofounder of Mobilization Against AIDS and picketed then Rep. Barbara Boxer, now US Senator and AIDS supporter,to get the Democratic controlled House and Senate to hold congressional hearings. A week after our picket the hearings were scheduled. It wasn't just the Republicans being unresponsive at the beginning of the epidemic.

My efforts to educate the community about poppers is one facet of my activism, both past and current. Prevalence of use, research results, popper industry promotions warrant attention to poppers..

if you google enough you will find Hank Wilson initiating the complaint against AIDS Denialists which resulted in their imprisonment for violently disrupting an AID Treatment Education forum...

The AIDS Denialists dont tell the whole story when they talk about poppers. Interestingly, Duesberg fails to cite the Dax human study showing that natural killer cell function is suppressed. I have no control over their inclusion of Hank Wilson in their websites.My work with John Lauritsen, co author of DeathRush, was prior to AIDS denialism emerging.

Fighting on multiple fronts is longstanding: the poppers industry; the AIDS denialists; the research community and its aversion to poppers because of the denialists focus on poppers; the HIV prevention/gay health education efforts which to date has failed to adequately address poppers;

Criticism and hostility is nothing new. Nor is support. Constructive feedback continues to be welcomed. Hank

Hank Wilson is not interested in debating the issues or addressing the science. He's simply into promoting denialism by stealth.

That's what this crap is all about.

It doesn't matter what reputable, peer reviewed science is presented to people like Hank or the AIDSmeds equivalent of the Unabomber, Bimazek, it just won't be good enough.

They've formed their views (ie poppers cause KS) and no amount of rational discourse will ever change that.

They're fanatics. You might as well try to convinced Osama Bin Laden that an independent Jewish state in the Middle East is a good idea. You'll probably have more luck there.

It doesn't matter that all the peer reviewed reputable science singularly dismisses the use of inhaled nitrites as even having any relationship to KS. The cause of KS is quite clear. Human Herpes Virus 8 + a deficiency in cell mediated immunity can lead to the development of Kaposi's Sarcoma.

It's not fucking rocket science. Sure, Hank and Bim have some antiquated discredited scientific papers from 1981, but it doesn't make them right.

So why does this matter?

Well it matters because not only skeptical and educated people like Philly, Tim Hunter and myself read this forum. Lots of people (almost all HIV positive) read this forum and it's quite possible that they will leave this place with the false impression that the Chicken Little's of HIV (eg Hank and Bimazek) have anything credible to say on this issue.

And they may make decisions regarding their health and personal safety based on the wildly erroneous and outlandish rubbish that Bim and Hank post.

But this doesn't mean that I think snorting poppers is good for your health. It's not. Inhaled nitirites and similar pharmaceuticals are powerful drugs. It's probably not a good idea to use them whenever the fancy takes one.

But if you do, whatever happens you won't develop KS as a result.

Hank is clever, I'll give him that. He produces dates and times and references and impressive sounding titles, but don't be fooled. None of that lends and credence to his central thesis.

Poppers do not cause KS.

And he can further attempt cloud the real debate by prattling on about how he single handedly formed the first response to HIV in San Francisco or turned base metals into gold in 1987 or what-the-hell-ever it still doesn't change a thing.

He's wrong. Poppers do not cause KS.

So by all means we should continue this debate. We can cite the same studies at each other over and over and over, but it won't make any difference.

Well it matters because not only skeptical and educated people like Philly, Tim Hunter and myself read this forum. Lots of people (almost all HIV positive) read this forum and it's quite possible that they will leave this place with the false impression that the Chicken Little's of HIV (eg Hank and Bimazek) have anything credible to say on this issue.

And they may make decisions regarding their health and personal safety based on the wildly erroneous and outlandish rubbish that Bim and Hank post.

But this doesn't mean that I think snorting poppers is good for your health. It's not. Inhaled nitirites and similar pharmaceuticals are powerful drugs. It's probably not a good idea to use them whenever the fancy takes one.

But if you do, whatever happens you won't develop KS as a result.

Hank is clever, I'll give him that. He produces dates and times and references and impressive sounding titles, but don't be fooled. None of that lends and credence to his central thesis.

Poppers do not cause KS.

Thank you Matty, this is most concise.

We all do the board a great disservice by allowing people with an agenda to distort facts and scientific research in ANYTHING to do with HIV/AIDS. It's very simple, as we all depend on sound reasoning to make all decisions with this very deadly disease.

Personally I'm very disappointed in the likes of someone like Hank Wilson, who obviously (see Tim's link) has done a lot in the community with PWA. I salute him for such activities. But that does not give him free license to peddle his own version of denialism which I will label "KS Denialism." He has repeatedly stated that he is not an AIDS denialist, and though a quick google might lend one to think this because of his mid-80's links to people who later became entrenched in the sort of disastrous denialism peddled for years by the New York Native by the very man he once wrote a book with, I've uncovered nothing that shows he continued to do so in the 90's or later.

HOWEVER, he employs the same sort of cherry picked facts and fallacious logic for his new pet project, KS Denialism, that the others do for AIDS denialism, and dismisses any criticism as not "constructive" and "hostile" JUST LIKE THEY DO.

Frankly it's appalling. And you're right Matty, the conversation goes nowhere. Any quick check of Hank/Smoothstone's past posts will show that once he's shown to be wrong he'll simply disappear for a few weeks and pop back up and start yet another thread with the same, tired false arguments.

HOWEVER, he employs the same sort of cherry picked facts and fallacious logic for his new pet project, KS Denialism, that the others do for AIDS denialism, and dismisses any criticism as not "constructive" and "hostile" JUST LIKE THEY DO.

Absolutely. Whilst these KS denialists are not flat out AIDS denialists, they all piss in the same pot as far as I can see.

I have to confess that Smoothstone's posts continue to confuse me in one very significant respect -- is he, or is he not, Hank Wilson? Smoothstone uses the third person to refer to Hank Wilson in his posts. Then he signs the posts with "Hank." So, Smoothstone, do me a favor and tell me, are you Hank Wilson or not? And if you are, in fact, someone named Hank Wilson, are you the same Hank Wilson honored by Project Inform? You're trying to use that fact as proof of your bona fides, but even assuming that AIDS activism is somehow relevant to a debate about the health effects of poppers (a dubious proposition, in my view), then you need to demonstrate that you're actually the activist in question.

Your elusive attitude suggests that you have something to hide, and it therefore does nothing to increase my confidence in the credibility of what you say. And as others have pointed out, you continue to flog the dead horse of "poppers cause KS," despite what appears to be abundant scientific evidence to the contrary. Matty's got it exactly right on this one -- many people read this board, and they may well be misled by incorrect information posted here. People with HIV have plenty enough to worry about without thinking that using poppers is going to give them a lethal form of cancer. We need to direct our efforts to dealing with real threats, not imaginary ones.

I am not claiming that poppers cause KS. I am claiming that poppers are immunosuppressive, and are a candidate cofactor for HHV-8 infection and development of KS. I will continue to correct your error.

Smoothstone is Hank Wilson, a longtime gay and PWA activist with KS, honored by Project Inform in 2006. The inclusion of the PI info was in regards to erroneous allegations that I was an HIV/AID denialist, or denialist collaborator.I have a long history of AIDS activism including combating HIV denialism. The fighting HIV denialists is part of court records in SF. I co authored a Guest Editorial in the SF Chronicle confronting the HIV denialists. Google search will verify Chronicle editorial. I have also been honored by Shanti Project,Mobilization Against AIDS, Stop AIDS Project, SF Pride Community Grand Marshall. I served multiple terms on UCSF Center for AIDS Prevention's Community Advisory Board and am a co author of a pending article on Disseminating Research findings.

I do not now claim that poppers cause KS.Historically, in 1981, I founded The Committee to Monitor Poppers and cautioned the gay community that poppers could be immunosuppressive, be the cause or cofactor in the mysterious new illness(first called GRID, renamed AIDS) and cause or be a cofactor for KS. HIV was discovered and the concern about poppers was narrowed to cofactor role. When HHV-8 was discovered in 1994,the concern about poppers narrowed immunosuppression and cofactor role in HHV-8 infection and KS.

I contend that poppers are immunosuppressive and a cofactor which facilitates HHV-8 infection and/or development of KS in some, not all, gay men. Most gay men with HHV-8 have not progressed to KS. Are there factors which distinguish those with HHV-8 who progress to KS and those who do not? Does exposure to HHV-8 in saliva always result in HHV-8 infection? What is the effect of frequency(number of days per month) of popper use? Is quantity( number of sniffs) of popper use a factor in degree of immunosuppression? Research may answer these questions.

At a minimum, people inquiring about poppers should be advised that a research record exists, and that the question if poppers are immunosuppressive and increase susceptibility to HIV and/or HHV-8 infection continues to be research. That there is no consensus to date.

The Committee to Monitor Poppers made constructive contributions to HIV prevention efforts producing educational pamphlets 1985, 1998,2000. the point of sale warning mandate laws passed in 1983,amended in 1986, and our challenges against the distortions, omissions, promotions made by the popper industry. In 1983 CMP started distributing(for free) research bibliographies to researchers and service providers and interested community folks and distributed over 400 at the Toronto Intl AIDS Conference in 2006. A Los Angeles chapter of The Committee to Monitor Poppers successfully lobbied for a 1991 federal ban on sales of alkyl nitrites. Those efforts are part of the historical record. Controversy about poppers predates the AIDS epidemic.

The Committee to Monitor Poppers has a poppers information website at http://poppers.cfsites.org including bibliography of research on poppers and immunosuppression and HHV-8/KS. The website is a work in progress. Questions, feedback are welcome. Hank Wilson

At a minimum, people inquiring about poppers should be advised that a research record exists, and that the question if poppers are immunosuppressive and increase susceptibility to HIV and/or HHV-8 infection continues to be research. That there is no consensus to date.

It would appear that there is "no concensus" on this issue in the same way some claim that there is no consensus on whether human activity is contributing to global warming or, more pertinently, whether HIV causes AIDS. Yes, one can find a few outliers who say that human activity isn't heating up the planet or that HIV doesn't cause AIDS, but the overwhelming bulk of peer-reviewed data indicate the opposite.

I must say that what strikes me most about this entire trumped up controversy is how weird it is. With all of the issues that people with HIV must confront, why on earth are you making such a big deal about this?

I think we've hashed this out long enough. I'd like to move that the moderators close this thread, or at least limit it to a true discussion of KS. Can I get a second for my motion?